SSRI's to Mood Stabilizer (lamoTRIgine)

[Soccer_Dude]

Well, after a couple of bad starts with SSRI's, my MD didn't want me to try another until we got a second opinion.  I went to see a psychiatric nurse practitioner, and explained my symptoms and experience with SSRI's, and she thought it was best for me to try a mood stabilizer, to help calm things down in my  brain.  She prescribed lamoTRIgine (LaMICtal).  She made it sound like it was safe and wouldn't be too many side effects other than the RASH you need to watch out for.  I'm a bit scared to try something new espeically a anti-siezure med.  She made it sound like it would help with my symtpoms and would also help with serotonin, etc... She said they don't know how it works... Anyway, so many unknowns. I would rather try another SSRI, but not sure if I would  react well to another.  Has anyone tried lamoTRIgine (LaMICtal) for anxiety, panic and depression?  Does it help?

Thanks.

[coeus]

Lamotrigine is typically prescribed for individuals who suffer from bipolar disorder and epileptic symptoms. There are no official indications that the medication can be used for anxiety disorders and unipolar depression/major depressive disorder.

A systematic review conducted by Amann, Born, Crespo, Pomarol-Clotet and McKenna (2010) highlighted that there was no support for Lamotrigine as means for treating unipolar depression. They examined three unpublished studies that didn't show significant improvement in symptoms for those diagnosed with unipolar depression.

As for studies regarding the efficacy of Lamotrigine towards anxiety and panic - there's very limited articles demonstrating whether it can be effective for treating anxiety and panic symptomology. One study (Masdrakis et al., 2010) showed that an administration of Lamotrigine (200mg/day) was associated with one patient's reduction in agoraphobic avoidances and decreases in panic symptoms.

Bear in mind that these studies can be narrowly focused and only gives you a small picture of the evidence for Lamotrigine.

I have never used Lamotrigine and wouldn't advise the use of it given that it's a mood stabiliser. The psychiatric nurse practitioner is right in saying that the mechanism is unknown as to how it may help with changing the serotonin in your brain. I would suggest for you to consult your MD, GP or another psychiatrist before using Lamotrigine. Be well informed before you make any decision.

Good luck.

[Soccer_Dude]

Thank you for the info.  I wasn't so sure after only a 30 minute meeting that this was the right choice for me.  She just said that it would help calm the brain down, but not sure if that is true or what.  I tried one tablet Friday night.  I felt really low all day Saturday.  I don't think it made me feel very good. But, there's always the start up side-effects you have to deal with.  Anyway, I'm just trying to find the right thing to help with my brain that seems to be over active and easily gets anxious.  As I mentioned in previous posts, this was never an issue until one day it just hit me.  Now I'm sensitive to stress about anything.  I seem not to do well with meds so I'm not sure what will work.  Should I try a 3rd SSRI like Lexapro, or.....I'm trying a natural approach again, at least until I can figure out another way.  I will definately talk to my MD on Monday and hopefully connect up with a true Psychiatrist who will spend more than 30 minutes with me to determine the best way to go about this.  I'm also waiting for test results to come back from my Endocrinologist, who's testing for some specific things, and maybe something will turn up that needs adjusting that will make all the difference. We'll see.  Again, thanks for your post.

Soccer Dude

[coeus]

No problems.

One day of the medication won't show any promise in highlighting whether you can cope with the medication or if it's the right one for you. Medication is a personal choice for people and it should remain as a sole decision for the person opting to take it or not.

There are certainly natural and helpful methods in supporting your anxiety management. Physical exercise is a fantastic way to help you cope with the sensations and symptoms of anxiety. Therapy can be of enormous benefit in helping you examine your turbulent thoughts and how to deal with your condition. Don't overlook natural exercises as a way to complement your recovery.

If you choose to continue to take medication, integrate complementary methods to help your recovery. There are heaps of posts on this forum describing many beneficial ideas on how to help yourself recover.

Good luck.

[Irishmanwrites]

Soccer Dude: I mean this with the greatest respect, but I don't think you are giving the SSRI's sufficient time..

Would you accept this?

You should really try six weeks.

[Soccer_Dude]

Hi Irish, I know you do.

I know you need to give SSRI's more time.  But, with the way I felt, it was the most scariest uncomfortable feeling I've ever had.  Not sure if I should feel that way when taking an SSRI.

I did discover something that might have contributed to my SSRI failures.  About the time I started taking Paxil, I started taking Maca root powder.  You can look it up for more info.  And I took it during the two weeks I took Paxil, and the week I was on Zoloft.  And I've been taking Maca up until today. I had taken one dose yesterday morning, then went to the coast for the evening, and didn't take it again until about Noon today. I typically take one scoop in the early morning and one around lunch time.  Some of these aweful feelings I've been getting occured after I took Maca, aong with some other things I'd take. Not every day, but most of the time I'd feel pretty yukky in the morning, but would feel better in the evening.   Well, today, I didn't take it in the morning, feeling fair, but an hour after I took it around Noon today, I got really ill feeling, anxious, depressed, etc... And after some research it seems others might have experienced some of the same stuff, and recommend taking smaller amounts and working up, although I've been taking quite a bit twice daily. I also started a new brand today which I think is more potent.  So, the Maca might be contributing to some of how I've been feeling, or at least increased the symptoms I already had. I'm stopping Maca altogether and we'll see how I do.

I will talk to my MD and psychologist that I see in a week or two about SSRi's again.  In the mean time I'm taking a special St. John Wort formula to see how it goes.

Soccer

[Irishmanwrites]

The maca is without doubt a bad idea. Glad to hear you're off it.

A word to the wise, SSRI's cannot be taken with ST Johns Wort or SJW formula. I'd think very strongly before trying the wort, as it can restrict your more likely to be successful med options shortly.

I would echo the above poster re lamictal, a serious med.

What about trying an SSRI with a benzo for the first month?

[Soccer_Dude]

Hi,

I do understand that I can't take St. John's  Wort with a SSRI.  If my MD decided to try another SSRI, I wonder how long I need to go off St. Johns Wort before starting a SSRi?  I thought I read you could just go off it, and start up a SSRI, maybe a day's wait, but I don't recall for sure.  Do you have any ideas?

I'm on the 2nd week of St. John's Wort, so I could start feeling the benefit from it soon.  What if it works? But, what if it doesn't.  :)

I've been having adrenaline surges lately, and feeling a bit off.  And my sides ache.  Not sure if my adrenals are having issues or what.  I wish i could figure this all out. :)

I'd be open to trying another SSRI if that is the only option.  I'd hate to use a Benzo along with after my experience with Xanax.  I have some avitan right now for just in case.  How much can you use without becoming addicted and having to go through withdrawal protocols?

Thanks.

Soccer
Soccer

[Soccer_Dude]

I think I'm having low cortisol issues right now.  feeling anxiety, adrenal surges, a little shaky, a bit sweaty, extreme hunger even shortly after eating, lighheaded/woozy feeling, sides ache, etc...This all occured after my last does of Maca yesterday. Not sure if it threw off my endocdrine system, as it's supposed to help not make things worse. :)

[Soccer_Dude]

FYI - I added a couple of posts above this one incase you haven't read them.

Anyway, if I was to try another SSRI, any recommendations? I know there are many, and I know everyone reacts and responds differently to each med.  I tried Paxil, and not too happy about how that one made me feel, and I hear it's a bugger to withdrawal from, and Zoloft seemed to not be very friendly to me either, but I hear it's easier to withdrawal from, but I had been thinking about Lexapro.  Any thoughts on Lexapro?  How is it for a side-effect profile? What about withdrawal?

Thanks.

[Irishmanwrites]

Hello Soccer Dude,

My advice as a layperson and not a doctor would be to consider the following:

Make an appt with your doctor

Discuss your fears and excessive self analysis on a med

Ask for a trial script of Lexapro

Ask for a trial script of Klonopin

Take the Klonopin under doctors orders for few weeks max

Start the lex at 5 for a month

Move to 10 then and progressively to 20MG's.

I'm on 30mg and have zilch side effects

Get some CBT in addition to Meds.

Best.

[Soccer_Dude]

Hi,

Thanks for the tip.

How soon can you expect to feel a difference in depression and anxiety?  I've read reviews where people actually feel a difference right away, where others take a lot longer.

I'm also trying to find information about how long I would need to go off St. John Wort before starting a SSRI... Does St. Johns Wort down regulate the serotonin recepters like a SSRI?

Soccer

[Irishmanwrites]

Realistically, about six weeks and that's a minimum

[coeus]

Hi Soccer Dude,

If you plan to start taking a SSRI and are currently on St. John's Wort - you'll need to allow typically two weeks to come off the St. John's Wort. In most antidepressant information leaflets, it is advised that you do not take a combination of antidepressants with St. John's Wort as it could adversely result in a serotonin syndrome.

I would suggest to give at least completely two weeks to come off the St. John's Wort before deciding to start taking a SSRI.

Always consult your GP if you need a professional opinion on discontinuing St. John's Wort and if contemplating to take an SSRI.

[Irishmanwrites]

Coeus has correctly echoed my warning re SJW and SSRI's and given wise words re a gap period and speaking to your doc.

I wonder given the reality of another prescription when you see your doc of whether you should drop the SJW now. I would.

[Soccer_Dude]

I've decided to drop SJW as of today anyway, whether I take another SSRi or not.  I think it's been causing my adrenaline surges, insomnia, and as of two days ago, very low mood, nausea, dizziness and lack of appetite.  The insomnia has been growing worse the 2nd week on SJW. Didn't think it was related.  Then two days ago, when I took my last Maca, I had also taken SJW, and fell into a very poor mood, pressure in my head, and all the symptoms I listed above. Not sure if it was the Maca or the SJW catching up to me. So, I've dropped Maca (which my ND also recommended), and I'm not going to take SJW any longer. I've on other sites where people have had similar reactions to SJW as I seem to be having now.

I just worry that by body can't tolerate SSRI's, and that another will just cause more harm than good.  I have an appointment with a real psychiratrist on Feb 14th, so that should be long enough to be off SJW if they suggest another SSRI.  I just hope they also don't recommend lamoTRIgine.

Soccer

[Irishmanwrites]

Soccer, I'm glad you're off the SJW.

Feb 14 is one week and two days away, hang in there.

Can I just emphasise though that when you see this psychiatrist and receive your prescription, you really must stop second guessing or doubting it or looking online. The advice is you must turn off the Internet. It only adds to worry, seriously in your case.

You must turn off the Internet and do a proper trial of six weeks, absolute minimum.

[Soccer_Dude]

Hi Irish,

I have a question about SSRI's.  I hear that if you aren't depressed that it can make you worse?  My symptoms started as anxiety, bad anxiety, got a bit better after Xanax, then got worse, and then panic like symptoms, and then I think because of all this, there is a sense of depression that has set in.  And I think over the years, there was little tiny bit of depression, although it was nothing I ever thought of until I look back.

Is an SSRI still the best option for anxiety, with depression.  I guess there's depression with anxiety and anxiety with depression but as someone mentioned it's all one and the same. For the past several months I've been taking 5-htp and L-tryptophan supplements, so I'm assuming my brain level of serotonin might not be that low.  Is a SSRI still needed? Just wondering what your thoughts were.

I thought depression was more when people are very sad. I'm not sad.  I have lost interest in things I normally do, I don't get that excited about things any more, and I struggle to get out of bed some times because I dred another boring no-feel-good day.  I feel anxious about a lot of things, and I get depressed and anxious when I think about all the crap I've been through, all the dr. visits, and wondering if I will ever get better.  Is that depression or anxiety, or both?

Anyway....

[Soccer_Dude]

One more thing...

I continually get this pressure in the back of my head. When it's there, I feel very depressed, and fearful. Not sure why. It's a scary feeling.  Not sure what could be going on.  I wouldn't think that a head pressure/ache would cause depression, could it?  Or, maybe it's not depression, but a panic feeling, but it makes me feel death for some reason. When the head pressure is not there, I feel a lot better. It comes and goes, but has been around more lately, especially in the mornings, but now for the past two days, it's been there consitantly.

Anyway...not sure what would trigger this head pressure. It all started while I was on Xanax months ago.

[Irishmanwrites]

Hi Soccer Dude,

I'm sorry, but I don't feel it's beneficial to keep answering your questions. I feel it just fuels further questions. Behind the questions lie anxiety and we are fuelling your anxiety by answering your questions.

Without being harsh, you need to turn off the Internet and take a proper trial of a medicine.

I would encourage other posters not to continue fuelling anxiety. 

Another example of this, in the time it took me to reply you've added another unhealthy post.
Cruel to be kind and all.

 

[coeus]

Irishman is simply being pragmatic about your situation and he is right in saying that we have to be proactive in managing our anxieties and conditions.

I would like to emphasise that self-diagnosis is not helpful in understanding what you're going through. Psychoeducation in moderation is beneficial in discovering what may be causing those symptoms but if you are fearful that your anxiety and/or depression are interfering with your daily functioning, I would highly suggest that you consult your GP or therapist.

To sum up Irishman's sentiments and my own: decide whether or not to discontinue St. John's Wort (if so, allow at least two weeks for complete discontinuation), consult your GP about your concerns about your anxiety and possible depressive symptoms, and seek therapy if you deem it necessary.

A competent therapist will be able to help you better understand your symptoms with provide further professional guidance.

Good luck.